REMEDIUMREMEDIUM1561-59362658-3534Joint-Stock Company Chicot116110.21518/1561-5936-2019-11-47-52Original ArticleEfficacy of original bacterial lysate in COPD affected by comorbidity: pharmacoeconomic aspectChelenkovaIrina N.noemail@neicon.ruOlefirYuriy V.noemail@neicon.ruKrylovIlya A.noemail@neicon.ruBunyatyanNatalya D.noemail@neicon.ruScientific Centre for Expert Evaluation of Medicinal ProductsNorthern State Medical University1112201911475218032022Copyright © 2019,2019Chronic obstructive pulmonary disease (COPD) is a common respiratory disease that is one of the major causes of disability and mortality of patients. Objective of the study: clinical, pharmacological and pharmacoeconomic study of the effect of oral bacterial lysate (BL) - pathogens of respiratory tract infections on the duration of the stable course of COPD and hospitalization rate in patients with different risk factors and comorbidity - the presence of chronic kidney disease (CKD) and cardiovascular disease (CVD). Methods of the study: clinical, pharmacological and statistical research methods: retrospective review of inpatients' records, assessment of the patients' quality of life, identifying subgroups of patients with cluster analysis, pharmacoeconomic ABC/VEN analysis of drugs used to treat COPD, the most financially intensive drugs were determined. Determination of current and expected drug treatment practice for COPD, cost-effectiveness analysis, pharmacoeconomic assessment of use of BL in the complex pharmacotherapy for COPD of moderate severity was carried out to analyse the costs and impact on the budget. Results and discussions: the investigational BL prolonged the duration of stable course of the disease in patient clusters of different comorbidities, but along with this significantly increased the period until the next hospitalization due to exacerbation of COPD only in patients with concomitant CKD. Conclusions: the inclusion of oral BL in the pharmacotherapy regimen for COPD results in the reduction of financial costs (by 14% per patient a year) while relieving the symptoms of COPD and improving the patients' quality of life.COPDlysates of pathogen bacteriapharmacoeconomic efficacychronic kidney diseasecardiovascular diseasesХОБЛлизаты бактерий-возбудителейфармакоэкономическая эффективностьхроническая болезнь почексердечно-сосудистые заболевания1.Авдеев С.Н., Айсанов З.Р., Белевский А.С.и др. Новые возможности в профилактике обострений хронической обструктивной болезни легких. Заключение группы специалистов Российского респираторного общества. Пульмонология. 2016;27 (1):108-113.2.Авдеев С.Н. Значение обострений для пациентов с ХОБЛ. Эффективная фармакотерапия. Пульмонология и оториноларингология. 2014;(2):36-41.3.Ишмурзин Г.П. Медико-экономические показатели амбулаторного и госпитального лечения пациентов с хронической обструктивной болезнью легких и бронхиальной астмой при экстренной госпитализации. Казанский медицинский журнал. 2016;97 (6):950-957.4.Калюжин О.В. Топические бактериальные лизаты в профилактике и лечении респираторных инфекций. Оториноларингология. 2016;2 (2):70-74.5.Тришина В.В., Бычкова Л.В., Федоренко М.Г. и др. Особенности влияния ХОБЛ на развитие почечной патологии и идентифицирование характера поражения почек с использованием специфических маркеров. Вестник РУДН, серия Медицина. 2012;(2):76-79.6.Челенкова И.Н., Бунятян Н.Д., Трофименко И.Ю. Влияние перорального бактериального лизата на продолжительность ремиссии ХОБЛ: фармакоэпидемиологическое исследование. Ремедиум. Журнал о российском рынке лекарств и медицинской технике. 2015;(4):49-52.7.Чучалин А.Г., Айсанов З.Р., Авдеев С.Н. и др. Федеральные клинические рекомендации по диагностике и лечению хронической обструктивной болезни легких. РМЖ. 2014;(5):331-347.8.Han M.K., Agusti A., Calverley P.M., Celli B.R. et al. Chronic obstructive pulmonary disease phenotypes: the future of COPD. Am J RespirCrit Care Med. 2010;182(5):598-604.9.http: //www.who.int/respiratory/copd/burden/en/10.Avdeev S.N., Aisanov Z.R., Belevskiy A.S. et al. New opportunities for prevention of exacerbations of chronic obstructive pulmonary disease. Russian Respiratory Society Expert Opinion. Pulmonology. 2016;27 (1):108-113.11.Avdeev S.N. Importance of relapses in COPD patients. Effective pharmacotherapy. Pulmonology & Otolaryngology. 2014;(2):36-41.12.Ishmurzin G.P. Medico-economic performance of treatment of patients with chronic obstructive pulmonary disease and bronchial asthma in case of emergency admission. Kazan medical journal. 2016;97 (6):950-957.13.Kalyuzhin O.V. Topical bacterial lysates in the prevention and treatment of respiratory infections. Otorinolaryngology. 2016;2 (2):70-74.14.Trishina V.V., Bychkova V.V., Fedorenko M.G. et al. Influence of COPD on the development of renal disease and identification of nature of kidney with specific markers. RUDN Journal of Medicine. 2012;(2):76-79.15.Chelenkova I.N., Bunyatyan N.D., Trofimenko I.Y. The effect of oral bacterial lysate on the duration of COPD remission: a pharmacoepidemiological study. Remedium Journal. 2015;(4):49-52.16.Chuchalin A.G., Aisanov Z.R., Avdeev S.N. et al. National clinical17.Buist A., McBurnie m., Vollmer W. et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007;370:741-750.18.Cazzola М. et al. Pulmonary Pharmacology and Therapeutics 2015;31:68-78.19.Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. https://goldcopd.org/20.Landis S.H., Muellerova H., Mannino D.M., et al. International Journal of COPD. 2014;(9):597-611.21.Mathers C.D., Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3: e442.22.Safka K.A., Wald J., Wang H. et al. GOLD stage and treatment in COPD: a 500 patient point prevalence study. Chronic Obstr Pulm Dis. 2017;4(1):45-55.23.Yach D., Hawkes C., Gould C.L., Hofman K.J. The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA. 2004;291:2616-2622. guidelines on diagnosis and treatment of chronic obstructive pulmonary disease. RMJ. 2014;(5):331-347.24.Han M.K., Agusti A., Calverley P.M., Celli B.R. et al. Chronic obstructive pulmonary disease phenotypes: the future of COPD. Am J RespirCrit Care Med. 2010;182 (5):598-604.25.http://www.who.int/respiratory/copd/burden/en/26.Buist A., McBurnie m., Vollmer W. et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007;370:741-750.27.Cazzola М. et al. Pulmonary Pharmacology and Therapeutics. 2015;(31):68-78.28.Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. https://goldcopd.org/29.Landis S.H., Muellerova H., Mannino D.M., et al. International Journal of COPD. 2014;(9):597-611.30.Mathers C.D., Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3: e442.31.Safka K.A., Wald J., Wang H. et al. GOLD stage and treatment in COPD: a 500 patient point prevalence study. Chronic Obstr Pulm Dis. 2017;4 (1):45-55.32.Yach D., Hawkes C., Gould C.L., Hofman K.J. The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA. 2004;291: 2616-2622.